Book review

This is a very good book for what it does. It introduces readers to public service ethics and that is something that is very much worth doing. It’s not that public servants lack ethics or that the public need instruction about how and why to be impatient with public service, the point here is that it is a commendable project to make ethics and debates about ethics understandable to everyone involved.

Ps ^e most interesting chapter in the book, because an iWl?tings and philosophy are presented very fully, the tr a is good, and the subject fascinating. His bladder W1 fortunately remains urmientioned until near the end, is ere ^ does no harm to the narrative. Catherine the Great ? C?nsidered almost entirely from the view-point of her su ^ excursions. But these are insignificant beside the herCeS'S which she ruled Russia. They do not explain ^lea^ness' they scarcely serve to emphasize it. Here ' a woman born of undistinguished parents, who cohabited W'h?^arn?USlyr with a series of twenty-three temporary , ands, who lived to the age of sixty-seven, earred the afte be reckoned among the greatest rulers, and won the WnCtl?nate admiration of the English letter-writer, Maria ttia Surely she was something more than a mere nymphoa? la?' ^here seems little excuse for Beau Brummell's presence Patient in Mr. Kemble's consulting-room. True, he died the signs of sclerosis of the cerebral arteries, but this degeneration was the result rather than the cause of his mode of life. The sketch of Omar Khayyam gives an enchanting picture of the poet's environment in Persia, but how much we know about the real Omar and how many of the quatrain? attributed to him are his was a puzzle even to the late Professor E. G. Browne. In any case the absence of material for a psycho-pathological study makes the chapter on Omar the most charming in the book. John Milton we have left to the last because it is a longer study than the others, occupying 60 out of the 184 pages of text. The author seems to have little love for Milton. He dislikes his treatment of his wives and daughters, he dislikes his political pamphlets and dislikes most of all his views on divorce. He takes an unconscionable time in telling his readers that Milton suffered from " gutta serena " which, as it was accompanied by pain and haloes round the candle-lights, can on]y have been " glaucoma.
Perhaps Mr. Kemble was not taught this as the classical illustration of glaucoma in his student days, as the reviewer was some forty years ago. (isle non fuit ordinatus) ; on ^ h March following he was advanced to be sub-deacon, and ^J'ear later to be deacon, and finally on 10th April, 1395, be priest. This brings his age to close on sixty. He was admitted to full membership of the Augustinian order, .r was he ever a canon. The executrix who proved his Jdescribed him as " Dominus " and " Capellanus," an is f)ene^cec^ priest who acted as a chaplain. No explanation of Pi^coming the reasons for his spending so many years nis life a resident in the Priory, educated like a cleric, , 1 unordained and unprofessed. Here he devoted a great ai of time and industry to making compilations from the a y authors of his own time and of antiquity. Greek, abian, Latin and Mediaeval writers were all laid under an u^ion by him, yet over and over again he disclaims part in the theories and opinions which he quotes so freely, ed't C^aP^er 011 " The Signs of Death," even though the a 0rs describe it as a " Mixture of Science, Nonsense and q Petition," and the chapter on " The Treatment of r ^^ttiption " are so well compiled and written that the uer cannot help wishing for more. Phthisis, defined as a aStincr nttto-*t ~-P + Price ?5 5s.?Zoologists are indebted to Professor F. H. Edge worth for this review of a specialist field in which he has been an important contributor for many years. The Cranial Muscles of Vertebrates collects together all the knowledge in this field, which in itself would be a signal service to comparative anatomy, but it does not stay here. This knowledge is arranged and analysed, and from the general principles collected together there emerges an attempt to follow the genetic relationships of the vertebrata and so ultimately " the phylogenetic history of man in the remote past." The work starts with a discussion of the mesoderm of the head and of the number of branchial segments in the primitive gnathostomatous vertebrate stock. The process of cephalization is followed, and shown to be essentially a backward extension of the cephalic mesoderm, resulting i11 the atrophy of the anterior body myotomes. This process is an important factor in the development of a neocraniuU1 out of the original palseocranium. From this starting-point the various muscle groups in the head are discussed one by one in great detail for each vertebrate order, and in addition there are important references to the innervation of the muscles and to the skeletal anatomy of the head where necessary. In the short space of a reviewer's note there is no room to indicate the amazing mass of facts which have been collected together and analysed. It must suffice to say that there is a thorough survey of every important problem in every group. Professor Edge worth has not only read the literature of his field, he has in many cases examined the material on which other workers' conclusions are based, and he has personally made important contributions in every aspect of the field. The difficulties of his work were immense-Some of the vertebrates examined are very rare, and nothing but lr|defatigable interest could overcome the problems of merely obtaining them, let alone carrying out the examinations.
Planes, and that the data presented are objective facts and n?t subjective inference. Professor Edgeworth's final contusions are by no means acceptable to all comparative ^?latomists. In the last two chapters is a summing up of his ueories.
A discussion of the homologies and innervation 01 the cranial muscles shows how difficult it is to obtain enable criteria of homology, which are essential for making P biogenetic analyses. The factors which can confuse the facts in a few words, and to the excellence of the mechanical aspects of production.
There is an index of cranial muscles, cartilages, and nerves, and a complete list of terms and abbreviations which are always so well chosen that in looking at a figure one hardly has to refer to the index. The table of synonyms is stated by the author to be far from complete. This may be so, but it extends through forty pages and does much to clear up the difficulties which arise from the lack of uniform nomenclature. A long list of references collects together all of importance to a date just prior to publication. And finally there are the figures, 841 in number, occupying nearly 200 pages. The majority are original, but derived figures are also used so that every point is well and clearly illustrated with excellent drawings. The Cambridge University Press must be congratulated on the style and production of the book. This work is essential to any specialist worker in this field, and cannot be neglected by other zoologists or anatomists simply because of its very wide implications. It is a vast storehouse of material so well arranged and presented that at every moment it serves not only as a store but as a stimulus for new ideas and for neW lines of work. It is indeed a commendable pattern of logic and objective study. ?This is certainly the most ingenious and original atlas of human anatomy ; but it is also by far the most complicated and difficult to understand, and we cannot see that it attains its " synthetic " object. In the sections on arm and leg certainly the superimpositions of the transparent drawings begin by being clear and informative, but naturally the deeper the dissection the more structures are revealed, and clarity is lost. Indeed, the confusing mass of detail presented in the pterygo-maxillary region renders the interpretation and relation of structures impossible ; especially since here, as indeed throughout, the depth or plane of dissection is not specified, nor is there given any indication of what each drawing is particularly designed to show. The section of the brain is the most abstruse and indefinite of all, and we fail to see its value ; there is no view of the convolutions, the base, or mesial section, but merely a series of diffuse, detailed and disconnected sketches which convey the impression that the brain is a pancake here cut into thin slices. And though We are aware that the contents of the orbit are diverse and complex in arrangement, we have not hitherto been consented by them in the form of a pyrotechnic nightmare.
jun^or student studying anatomy for the first time with phis atlas may well be appalled and discouraged by the ^tricacies and details of the subject ; the senior, using it 0r revision, will surely find his recollection of actual discretions disturbed, distorted, and even devastated. Both, ^e assert, would gain far more advantage in expenditure of mae by reading their text-book and looking at its contoured gures (which do remind one of dissections) than by poring ^ver these flat and flattening complexities until exhausted 0 the point of exasperation. The most that either could Say is that his wondering pencil had checked off piecemeal ^ery single structure in the body by wading laboriously nr?ugh the bald list of names in the map references, with utle connection between them and, of course, no thought their functions. He will likely end with a befogged Impression of any region of the body?and a headache. Could ^ e obtain from even a prolonged study of these fluctuating aves a clear idea of, for instance, such a simple thing as origin, course and distribution of the median nerve ? e doubt it. The technical production of this work of great "our is a fine tribute to the publishers, printers and binders, this at least justifies the price of 45s. The student or Practitioner may be bemused by its novelty, and if he can , ?rd it buy it, feeling he likes to have it. It will lie on his elves. It is pertinent to add that any well-illustrated text-?k of developmental, descriptive, applied and surface atomy will cost him less and be of far greater practical je' He will need to have it, and will keep it on his n. iryjJusLiiemu ctnu me iiyperstiiemu, tJctui the an<^ Abilities : their reaction to bacterial invasion ; a , nervous system in the control and defence of the body, 0r fas holding in its recesses the emotional centres of faith ear.

Vitality and Energy in
Life moulds its forms, adapts itself to change, ^ers to habit. The author is discursive and admits some  repetition ; literary form, perhaps, would gain by correction and revision.
Clinical illustration is drawn from old masters, from the surgical life, from battle fronts and men massed there, and from what one learns from one's own grief and pain. Man is a sensitive, delicate creature, ill-fitted to his cosmos.
For the author there is a glamour in the daily practice of the village doctor : his is a lore which helps his neighbours, for he knows their idiosyncracies and nuances. Price 25s.?This is an excellent publication, interestingly written, profusely illustrated with illustrations which really do elucidate the text, and most superbly produced. The aim of the book is to present to the student (and which of us is not still a student?) the technique of physical examination and of eliciting physical signs. Then, in the words of the author, " an attempt has been made to take the student a stage further to the visualization of symptoms and signs as forming a clinical picture of some pathological process." In this endeavour he has admirably succeeded. After chapters upon the routine of interrogation and examination, and upon the external characteristics of disease he proceeds to take the various systems of the body and to go through them, pointing out how " symptoms and signs are pieced together in the jigsaw puzzle of diagnosis." Excellent chapters upon the examination of sick children, the simpler medical operations and instrumental investigations, and then one upon the ordinary examinations of clinical pathology and biochemistry follow the main part of the book. As is essential in a work of this character, the author is dogmatic in his statements and clear cut in his views. The work is really a glorified Clinical Methods, combined with a simple index of diagnosis, and the predominant feeling in at least one reader's mind is one of regret that if such works were produced in his student days he never had the good fortune to come across one.

Symptoms and Signs in
But surely one of the simpler diagrams of the false and true images in diplopia would have been easier to understand. The author is to be warmly congratulated upon this splendid production, and, as he himself is the first t? acknowledge, he owes a great deal to his publishers for their 1936. Price 8s. 6d.?In this small volume five authors have c?Haborated in presenting to the general practitioner the pssential points in making a provisional diagnosis of cancer, and ln urging the necessity of sending the patient to some hospital ?r other institution for expert opinion at the first suspicion ?f malignancy. The twelve chapters cover practically the ^vhole range of the commoner malignant growths with the Rotable, and regrettable, exception of intracranial neoplasms. J-ri most cases the admirable procedure is followed of contrasting forcibly the early symptoms and signs with the generally accepted classical evidences of the disease. The great value, and the limitations, of modern aids to diagnosis are stressed, in particular the expert use and interpretation ^ radiological, endoscopic and pathological examinations. 11 connection with the last-mentioned it is interesting to n?te that the dangers of biopsy of malignant tumours for eXact histological diagnosis are dismissed as unfounded, except in the case of bone sarcomata. The " precancerous " c?nditions receive due attention, and treatment is indicated 0nly in so far as its results emphasize the enormous value of early diagnosis and appropriate therapy by experts. The ?ok is well indexed and, probably wisely, devoid of any . lustrations or reference to current or past literature. Though 111 places the brief pathological descriptions are not strictly aecurate, the information is fully up to date, and the volume Should prove invaluable to senior students and young Practitioners, and a welcome encouragement to all whose aim it is to reduce the toll of death and suffering from cancer. Publishers are to be congratulated on their determination ? keep the Index of Treatment constantly up to date. Many the articles have been completely re-written and many Ue\v articles on subjects not dealt with in previous editions are included. Among the new articles are to be found the treatment of such important conditions as agranulocytosis, allergic diseases, alkalosis, functional diseases of the gallbladder and the anaemias of childhood.
The last-named (anaemias of childhood) form a most important and interesting group, which is fully and admirably dealt with. One feels that it is unnecessary to recommend the book ; it is too well known. All that seems to be called for is to draw attention to the appearance of a new edition. ^onceptions, but in this book the authors have devoted more half its volume to such advanced physics that it is ecessary to be a highly-trained physicist in order to underand it; and the physician and the biologist, for whom they j this book is primarily intended, would, therefore, find a Part of it unintelligible. A short, more elementary * ysical introduction dealing with the details of the apparatus . its method of use would render the book more valuable, Ce the beginner in this branch of therapy is given .^ively little information of this nature. The part dealing far medical uses is clear and interestingly written as ^ as it goes, and one is given the impression that the writers ? aVe a great deal more information which they do not feel ^Efficiently proved to justify its publication. The book is printed, has an excellent bibliography, but a rather ^vork ^n(^0x' translators are to be congratulated on their Emergency Surgery.
By Hamilton Bailey, F.R.C.S. Second Edition. Pp. xii., 842. Illustrated. Bristol : John Wright & Sons. 1936. Price 50s.?The appearance of a second edition bears witness to this book being a boon to surgical students, qualified and qualifying. An added appeal in the new edition is that the whole work is bound in one cover instead of two volumes.
Doctors are deluged with literary outpourings, and readily appreciate every simplification and compression of books as of other essential paraphernalia.
By restricting himself to what is of wholly practical value, the author encompasses the whole range of surgical emergencies completely. He is concise, but not to the exclusion of precision. Due regard is paid to the choice of instruments and minutiae of technique, on the faithful performance of which successful operating so often depends. Brightening up the sterner descriptions on surgical procedure are beautiful illustrations, many of which are coloured. Thrilling stories of actual cases, rescued by the author from grievous perils, emphasize the value of the methods he advocates, as, for instance, that told of the boy with injury of the lung (p. 432, et seq.). Occasional epigrams sprinkle the text and serve acceptably to " point a moral or adorn a tale." These fit aptly with the vigorous and impressive style of the production. Among the subject matter, blood transfusion receives the merit it deserves i*1 the opening chapter. Due attention is given to another popular helpmate of modern surgery, spinal anaesthesia. The bulk of the book deals most commendably and in fair proportion with the surgical crises of trunk, head and limbs, and in many parts improves on its predecessor. Thus, retrograde jejuno-gastric intussusseption is now included, as befits it, among the complications of gastro-enterostomy?
The more radical measures for treatment of ischiorectal abscess is a commendable addition. There is also told and depicted the Cabot method of nephrostomy. Where masses of detailed facts and reference have to be marshalled, a fe^v errata are but human. Thus, the meaning of the arrow i11 Fig. 208, p. 223, is obscure, while, presumably, the inversion of the illustration on intercostal anaesthesia (Tig. 411, p. 422) and of the tympanic membrane (p. 743), are oversights-Lane's forceps (Fig. 171, p. 185) are surely too coarse for handling bowel. Is the picture of an ampoule oi serum (Fig. 175, p. 194) worthy of space in this concise compendium ? However, if the readers of this book fail to do justice to their patients' needs, they must blame themselves and not it.

1935.
"rice 10s. 6d.?This is an excellent and well known monograph and has now reached its seventh edition.
Several small alterations have been made, and some interesting and instructive observations on the value of X-rays in the diagnosis of intestinal obstructive conditions have been added. As its name indicates, the book confines itself entirely the question of diagnosis, with a wealth of detail in regard to symptoms and signs. The first chapter deals with several sound elementary principles and observations in relation to ^^gnosis, and in the second chapter there is an admirable specimen form for history-taking in acute abdominal cases, -^he book is well printed in good size type, and there are Numerous good diagrams. There is an accurate and detailed lndex which makes reference to any particular point quite easy. This is a valuable guide to practitioners in this Particularly difficult and urgent type of case. Pparently addressed to the deaf layman, with a view of ^ luainting him with recent progress in audiometry and the Ascription of aids to hearing specially modified for the needs of each patient : would that practice were as simple as the theory ! The statements that hydrogen peroxide is a simple solvent of cerumen ; that otosclerosis is a rheumatic condition ; and " since we know that too much smoking causes irregular action of the heart, hyperacidity and blurred vision, it is impossible that the nerve of hearing should escape the poisoning," sufficiently indicate the scientific value of the pamphlet, and such spellings as " asperin " its literary standard. " A fool is bent upon a twig, but wise men dread a "bandit." Which I think must have been clever, for I didn't understand it.
The pathetic reaction of Ferdinando to Mister Martin Tupper's cryptic utterance will occur to many of those into whose hands this volume comes. Only the favoured few who have already mastered the author's vocabulary and preliminary theses can appreciate its full beauty and value. It is devoted to the epidemiology of the common cold and influenza, with special reference to the mutation of bacterial species under the influence of cosmic rays ! It would appear that the astrology of ancient Nineveh was in reality an exact science-But we must remember that our author considers " disease as practically synonymous with "biology." Both the large size of pre-historic Saurians, and the cerebral development ^ichols, who has done his work admirably. The general i an of the book and its illustrations remain unchanged and good as ever. The chief addition is a chapter on " Gas oisoning in Warfare," a subject of which the editor has Undant first-hand knowledge, although he modestly says ^.at the chapter is based on the Official Air Raid Precautions audbook No. 2. We hope that the information contained ^ this chapter will reach a wide public. The chief value ^ Poisonous gases in warfare is their power of causing panic; s the author correctly observes, even in the case of mustard recovery is usual." Precautions against gas are easy Grange and most effective. Panic is the fighting factor, and a public that has read this chapter will not permit itself to be thrown into a panic. It is interesting to see air transport of casualties taking its place as an ordinary method. Without wishing to be unduly critical, one wonders whether the treatment of carbon-monoxide poisoning ought not to find a place in future editions. Mine-rescue is, of course, highly specialized work, but the employment of oxygen inhalation apparatus, oxygen-tents and Drinker's respirator is rapidly approaching the point where they should be included in " First Aid to the Injured." Aykroyd on Vitamins will be warmly welcomed. In his first edition the author produced a book which was acceptable to the medical and general reader alike. The new edition is no less readable, and it is a matter for congratulation that the temptation to include specimen dietaries and tables of food values has been resisted.
In a scientific discussion of fundamentals these would be out of place. The author presents scientific facts in a form and in a literary style that makes them intelligible to a reader with no physiological knowledge. Yet at the same time the established facts are so complete and so well arranged that there are few books to which the practitioner can better refer for the information he needs in his every-day practice. The habit of writing decimal parts without a cypher is dangerous, as the figures may easily be misread ; thus, on page 193 are to be found : " -62 of a kilogram " and " -4 of a centimetre." The correct printing of those figures is 0-62 and 0-4. Dr. Aykroyd has recently (in 1935) taken on the duties of Director of Nutrition Research under the Indian Research Fund Association, and in this edition a great deal of interesting information has been added on the enormously varied dietary problems of the Indian peoples ; for India remains one of the most dreadful fields for the study of food deficiencies of every sort. Books like Aykroyd's make one feel little doubt that economic and dietetic problems are of greater moment in world politic?
to-day than the dynastic and religious difficulties which used to form the basis of school history books.